368. Clinical Characteristics of Staphylococcus Lugdunensis-Associated Bone and Joint Infections
Session: Poster Session: Bacterial Diseases
Friday, October 7, 2005: 12:00 AM
Room: Exhibit Hall A
Background: Based on reports of Staphylococcus lugdunensis as the cause of a wide range of invasive infections, S. lugdunensis has been clinically distinguished from other species of coagulase-negative staphylococci as a highly virulent pathogen.
Methods: Following the institution of a systematic effort to microbiologically identify all clinical isolates of S. lugdunensis, we retrospectively characterized the experience of a large metropolitan, hospital specializing in bone and joint diseases with this organism.
Results: Over a 20 month period, 23 clinical isolates from 23 patients were identified, of which 7 were isolated from sterile body sites and deemed to represent bona fide pathogens based on sterile-site fluid characteristics, pathologic findings or the judgment of an infectious disease specialist. Five of these seven isolates were associated with infected prosthetic devices. All patients presented with a chief complaint of chronic pain of greater than 2 months duration. Only one of the seven patients was immunosuppressed. Fever or an elevated total leukocyte count at the time of presentation was uniformly absent. Two of the five patients with infected prostheses required removal of hardware and antibiotic treatment while the remaining three were treated with antimicrobials alone. In addition, we present a complete review of the published literature describing S. lugdunensis -associated bone and joint infections.
Conclusion: Contrary to previous reports, this experience demonstrates Staphylococcus lugdunensis-associated bone and joint infections do not follow a uniformly acute clinical course and that such patients may observe a clinical course indistinguishable from other coagulase-negative staphylococci.
David Gardiner, MD, Weill Medical College of Cornell University, New York, NY, Kyu Rhee, MD, PhD, Weill Medical College of Cornell University, NY, NY and   K.Y. Rhee, Cubist Pharmaceuticals Consultant / Advisor; D.F. Gardiner, None.

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